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Patient safety research from Manchester Pharmacy School at the University of Manchester (UoM) has reduced prescription errors in primary and secondary care. Pharmacists using our indicators with patients' electronic health records (aimed at preventing drug-related morbidity in general practices) reduced the odds of prescribing and monitoring problems by at least 22%. These indicators are now incorporated into `medicines optimisation' software for general practice computer systems. The EQUIP study led changes in the recommended design of hospital prescription charts, an annual national assessment of prescribing competence of medical students and the employment of extra hospital pharmacists to prevent the 9% of prescriptions with errors from harming patients.
Two major national studies, conducted by staff in the Unit and colleagues from a number of other institutions, provide the most comprehensive estimate to date of the prevalence of prescribing errors in general practice in England. These studies identified a number of strategies for reducing these prescribing errors that have been endorsed by the General Medical Council (GMC). Other impacts from these studies include increased public understanding and debate through media coverage, changes to GP education to be implemented by the Royal College of General Practitioners (RCGP), improvements to computerised prescribing decision support for general practitioners and increased awareness of the medication safety role of primary care pharmacists.
Our ground-breaking research has driven major changes in non-medical prescribing (NMP) legislation. As a result of our research, over 19,000 nurses and 2,000 pharmacists now independently prescribe medicines directly to patients across the most comprehensive range of medicines in the world. This amounts to four million prescriptions per year in England. NMP has improved the quality and efficiency of health care: patients can now access prescribed medicines faster and NMP has reduced the number of professionals required. Study results have also contributed significantly to a recent extension of independent prescribing powers to physiotherapists and podiatrists. Our research is widely cited in international NMP policy development, and our survey methods and evaluation measures are used to assess NMP quality and safety internationally.
Leeds researchers first proposed and tested the concept of a pharmacist-led clinical medication review and showed its effectiveness in care homes. This led to a collaborative study on medicines' safety in care homes which showed seven out of ten residents, on any one day, had at least one medication error. As a direct result, there was a ministerial-led summit, and the Department of Health (DH) issued a `Health Alert' requiring NHS trusts to take immediate action, citing the study findings. This was followed by several national initiatives to take forward the recommendations of the study, including a DH commissioned initiative involving Royal Colleges, the National Care Forum, the Health Foundation and Age UK. Prototype tools developed on the basis of our research and with Leeds input were reported in 2012 and are now being evaluated for national roll out.
Our research has: i) increased public and professional knowledge and understanding of the prevalence, nature and causes of prescribing errors in general practices; ii) led the General Medical Council to recommend improvements to GP education and training; iii) led to the Royal College of General Practitioners to revise its curriculum to increase the emphasis on safe prescribing; iv) led one of the major GP computer system suppliers to make safety improvements; v) identified an IT-based intervention that is effective at reducing prescribing errors; vi) led to the roll-out of the intervention in over 800 general practices.
Research by Cardiff University is contributing to initiatives within the NHS and across Europe to safely reduce unnecessary antibiotic prescribing and thus help contain antimicrobial resistant bacteria. Our researchers conducted observational studies of prescribing patterns linked to local resistance data and qualitative research with GPs and patients on their perceptions of acute respiratory tract infections and antibiotic use and resistance. This enabled the Cardiff team to develop clinician training and patient education resources (covering issues such as communication skills, point of care testing, and typical duration of infections) to reduce unnecessary prescribing. Our trials proved these interventions were effective, at times cutting prescribing by as much as two-thirds. Our research has provided the basis for new clinical guidelines, antibiotic stewardship initiatives and policies, and educational tools for clinicians and patients that are being used in the UK and internationally.
Self Organised Learning Environments (SOLEs), characterised by our innovative pedagogies and models of enquiry-based learning, are changing the culture of classrooms and inspiring many thousands of educationalists in schools and other organisations. This impact culminated in the 2013 award to Mitra of the annual TED prize ($1million). Teachers have been inspired to find new enquiry-based ways to encourage students to work together, solve problems and become more engaged in learning with minimal intervention from the teachers themselves. SOLEs have been implemented in schools and other educational institutions resulting in change in the attitudes and practices of teachers, head teachers, education policy makers, education experts and private companies. Impact has extended to 27 countries across 5 continents including India, UK, Argentina, USA, Australia, China, Finland and Qatar. This research has become a global phenomenon, influencing all phases of education (primary, secondary and tertiary) and also the training and development of teachers. The research also inspired the film `Slumdog Millionnaire'.
An internet-based care model developed by CSRI at Ulster, facilitating all stakeholders (patients, pharmacists, carers, GPs) to dynamically manage the prescription of, and patient compliance with, medication has been incorporated into the [text removed for publication] service platform produced by [text removed for publication], a Telecare product provider. This has extended functionality of [text removed for publication], which is now being used by over 400 patients in [text removed for publication], with improved levels of medication compliance, reduction in caregiver burden, and improved workflow management for healthcare professionals. Incorporation of video-based reminders further led to a material transfer agreement between Ulster and [text removed for publication] to extend [text removed for publication]'s functionality.